関: hypersegmented

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/02/24 14:21:07」(JST)

wiki en

Blood smear with two hypersegmented neutrophils.

A hypersegmented neutrophil is a clinical laboratory finding. It is visualized by drawing blood from a patient and viewing the blood smeared on a slide under a microscope. Normally, the number of segments in the nucleus of a neutrophil increases as it matures and ages, after being released into the blood from the bone marrow. Whereas normal neutrophils only contain three or four nuclear lobes (the "segments"), hypersegmented neutrophils contain six or more lobes.^[1]

Hypersegmented neutrophils have classically been thought to be pathognomonic of the class of anemias called megaloblastic anemias (anemias caused by failure of bone marrow blood-forming cells to make DNA, often caused by vitamin B₁₂ or folate deficiencies, or DNA-replication poisons). However, in seeming contradiction to this, several studies have strongly associated neutrophil hypersegmentation with iron deficiency anemia.^[2] In one study 81% of children with iron deficiency had hypersegmented neutrophils, vs. 9% of controls.^[3] The mechanism for hypersegmentation in iron deficiency is not yet clear, but has been suggested to be concurrent iron and vitamin deficiency.

One of the earliest, notable changes in the peripheral blood in megaloblastic processes is the appearance of hypersegmented neutrophils. Because of the short life-span of neutrophils, these abnormal hypersegmented neutrophils characteristically appear even before the onset of anemia in megaloblastic processes.^[4] Such neutrophils are less often seen in the other classes of anemia, which together are far more common than megaloblastic types of anemia. However, as noted, the use of hypersegmented neutrophils to diagnose type of anemia is limited by the fact that different types of nutrient deficiency anemia may coexist.^[5]

Note that pernicious anemia is a type of megaloblastic anemia, and as such, is expected to show hypersegmented neutrophils.

References

^ Clinical Laboratory Hematology, Shirly B. McKenzie and J. Lynne Williams - 2nd edition - Copyright 2010 - ISBN 978-0-13-513732-1
^ Westerman DA, Evans D, Metz J.Neutrophil hypersegmentation in iron deficiency anaemia: a case-control study.Br J Haematol. 1999 Dec;107(3):512-5.
^ Sipahi T, Tavil B, Unver Y. Neutrophil hypersegmentation in children with iron deficiency anemia. Pediatr Hematol Oncol. 2002 Jun;19(4):235-8. PubMed PMID 12051589.
^ Kumar, Abbas, Fausto, Mitchell. Robbins Basic Pathology 8th ed. 2007. pg 437
^ Westerman DA, Evans D, Metz J.Neutrophil hypersegmentation in iron deficiency anaemia: a case-control study.Br J Haematol. 1999 Dec;107(3):512-5.

This medical sign article is a stub. You can help Wikipedia by expanding it.

This article related to pathology is a stub. You can help Wikipedia by expanding it.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 貧血を有する成人患者に対するアプローチ approach to the adult patient with anemia
2. 赤血球産生低下による貧血 anemias due to decreased red cell production
3. 末梢血塗抹標本の評価 evaluation of the peripheral blood smear
4. 小児の栄養障害と関連した微量栄養素欠乏 micronutrient deficiencies associated with malnutrition in children
5. ビタミンB12および葉酸欠乏症の診断および治療 diagnosis and treatment of vitamin b12 and folate deficiency

English Journal

Early markers of occult megaloblastosis for low-cost detection of hyperhomocysteinemia in patients with ischaemic stroke: preventive approach for primary health care.

Neogi SS1, Thomas M, Sharma A, Kumar J, Khanduri U.
Canadian journal of physiology and pharmacology.Can J Physiol Pharmacol.2014 Sep;92(9):713-6. doi: 10.1139/cjpp-2014-0096. Epub 2014 Jun 27.
Recent studies have focussed on the association between elevated homocysteine levels with megaloblastic changes and thromboembolic events, but the relationship between occult megaloblastosis (with normal haemoglobin levels) and ischaemic stroke has not been widely explored. The objective of this stu
PMID 25068715

Nuclear hypersegmentation of neutrophils, eosinophils, and basophils due to hydroxycarbamide (hydroxyurea).

Xu X.
Blood.Blood.2014 Aug 28;124(9):1392.
PMID 25313414

Hypergonadotropic hypogonadism and hypersegmented neutrophils in a patient with ataxia-telangiectasia-like disorder: potential diagnostic clues?

Yoshida T1, Awaya T, Shibata M, Kato T, Numabe H, Kobayashi J, Komatsu K, Heike T.
American journal of medical genetics. Part A.Am J Med Genet A.2014 Jul;164A(7):1830-4. doi: 10.1002/ajmg.a.36546. Epub 2014 Apr 14.
Ataxia-telangiectasia-like disorder (ATLD) is a rare autosomal recessive disorder, and has symptoms similar to ataxia-telangiectasia (AT). ATLD is caused by mutations in the MRE11 gene, involved in DNA double-strand break repair (DSBR). In contrast to AT, ATLD patients lack key clinical features, su
PMID 24733832

Japanese Journal

臨床研究・症例報告好中球過分葉で発見された回腸広範切除後のビタミンB欠乏症の1例

弦間友紀,高木永,吉野浩 [他]
小児科臨床 65(1), 61-65, 2012-01
NAID 40019087653

Eosinophil hypersegmentation is a possible marker to monitor the disease activity of atopic dermatitis

YAMAMOTO Akemi,KOJIMA Takatsugu,AOKI Takao,SASAI Misa,TANIUCHI Shoichiro,KOBAYASHI Yohnosuke
Allergology international : official journal of the Japanese Society of Allergology 50(4), 325-330, 2001-12-01
NAID 50001008367